Archives ~ December 2008 Entries
Recently the British Medical Journal published a retrospective cohort study that followed just over 62,000 children from birth to age 10 to explore a hypothesis that medically attended head injury in children before age 2 may be causal in developing ADHD by age 10. Children that received burns before age 2 were also studied, and both groups were compared to children who before age 2 had neither a burn or head injury. The findings were somewhat compelling:
- Of the 62,088 children studied, 2782 (4.5%) suffered head injury and 1116 (1.8%) suffered burn injury before age
- Males had higher rates of injury in these cases
- The injured children were of greater deprivation, or lower socioeconomic class.
- The children who had already sustained a head injury/burn prior to age 2 had a higher percentage of head injuries after age 2.
- Children with a head injury before age 2 were TWICE as likely to be diagnosed as having ADHD as the comparison group, but not more likely that the burn group. Basically both head injury and burns doubled ADHD diagnosis before 10.
- In all 3 groups the risk of ADHD diagnosis increased among children who had a head injury AFTER age 2.
So what were the researchers conclusions? That head injury itself does not seem to be causal in the development of ADHD, rather that head injury prior to age 2 may be due to the increased risk behavior of those children with ADHD and can only be used as a marker, not a cause. Interestingly enough they also state that children with ADHD are more vulnerable to post-concussive syndrome with a mild traumatic brain injury.
Most of my practice deals with those who have sustained a traumatic injury of some kind, whether head, body, or emotional (likely all three). Many of the adults that I treat started having problems in childhood as a result of an UNTREATED head injury, and many of the children that I see have the ADHD diagnosis or would easily fit into the criteria. I am excited that the mainstream is looking at the correlation of these factors, but now the question is HOW ARE MILD HEAD INJURIES TREATED?
NCR has given me a whole new aspect of treating these patients by allowing me to remove the obstacle to cure and possibly save a child a lifetime of this diagnosis. Many parents who are reluctant to have their children treated after an injury state that they want to wait until the child is older, more mature, etc, but after looking at this study I must ask the question...WHY WAIT? Perhaps we can stop the negative sequeli of head injury now and spare the diagnosis of ADHD in the future.